NEW ORLEANS -- New mothers may be more likely to face an inconsolable baby if they have a history of migraine, an observational study suggested.

Action Points

Note that this study was published as an abstract scheduled for presention at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

Note that in this study, infants with a maternal, but not paternal, history of migraine were more likely to have colic at 2 months of age.

NEW ORLEANS – New mothers may be more likely to face an inconsolable baby if they have a history of migraine, an observational study suggested.

A maternal history of migraine conferred a 2.6-fold higher likelihood of colic in otherwise healthy infants (P=0.02), Amy Gelfand, MD, of the Headache Center at the University of California San Francisco, and colleagues found.

The prevalence of colic reached 28.6% for those babies compared with 11.1% among those without a migraineur mom, they reported in a study slated for presentation in April at the American Academy of Neurology meeting here.

"We really do not know what is happening when babies are having colic," Gelfand said in an interview with MedPage Today. "Traditionally it's thought to be abdominal pain, but we truly don't know."

These preliminary results, while not warranting any firm causal conclusions, suggest a different explanation for at least some infants, Gelfand noted.

"A family history of migraine is the strongest risk factor for migraine," Gelfand explained. "Our hypothesis is that mothers who have migraine have migraine genetics, which they are then passing on to their infants, and that those infants are perhaps expressing those genetics very early in infancy as colic."

Their frequent bouts of crying and fussiness for hours on end might be a signal of headache.

Or "babies with colic might be feeling sensitive to normal stimuli the same way that patients with migraine are often sensitive to normal stimuli during their attacks," Gelfand added.

If that is the case, pediatricians might consider counseling new mothers with a history of migraine to try cutting down on noise levels and other stimuli around their child during colic episodes, she suggested.

Some prior retrospective studies suggested that children with migraine were more likely to have had colic during infancy, but recall bias was a possibility.

To investigate a possible migraine-colic link, Gelfand's group conducted a cross-sectional study at general pediatric clinics in San Francisco, asking 154 mothers about colic at well-child visits at age 2 months, when colic is most likely, to minimize that source of bias.

Surveys of the fathers -- available for 93 of the infants – showed a trend for 2.3-fold higher likelihood of colic with paternal migraine.

The prevalence was 22.2% among infants whose fathers had migraine versus 9.5% in the others, though not a significant difference at P=0.24.

Colic was defined as unexplained crying or fussiness for three or more hours at least three days a week in otherwise healthy infants. Migraine history was considered positive if the parent either reported a physician diagnosis of migraine or screened positive with three questions on the ID Migraine tool.

One limitation was that the study didn't control for possible confounding factors.

Another study released last week in Pediatrics pointed to smoking and nicotine replacement therapy use during pregnancy as risk factors for colic.

Reverse causation was also a possibility, though unlikely, because mothers with and without migraine were equally accurate in their perception of colic when asked in different ways in the questionnaire, according to Gelfand.

Further follow-up is needed to assess whether the babies with colic go on to develop migraine more often, she added.

"It is important for us to understand what is causing colic because uncontrollable crying is one of the triggers for shaken baby syndrome -- for frustrating caregivers to the point where something like shaken baby syndrome can happen," Gelfand noted.

Gelfand reported having received support from National Institute of Neurological Disorders and Stroke and honoraria from Journal Watch Neurology.

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